Pelvic Range Of Motion Research Articles

Validation of Pelvis and Trunk Range of Motion as Assessed Using Inertial Measurement Units.

Trunk and pelvis range of motion (ROM) is essential to perform activities of daily living. The ROM may become limited with aging or with neuromusculoskeletal disorders. Inertial measurement units (IMU) with out-of-the box software solutions are increasingly being used to assess motion. We hypothesize that the accuracy (validity) and reliability (consistency) of the trunk and pelvis ROM during steady-state gait in normal individuals as measured using the Opal APDM 6 sensor IMU system and calculated using Mobility Lab version 4 software will be comparable to a gold-standard optoelectric motion capture system. Thirteen healthy young adults participated in the study. Trunk ROM, measured using the IMU was within 5-7 degrees of the motion capture system for all three planes and within 10 degrees for pelvis ROM. We also used a triad of markers mounted on the sternum and sacrum IMU for a head-to-head comparison of trunk and pelvis ROM. The IMU measurements were within 5-10 degrees of the triad. A greater variability of ROM measurements was seen for the pelvis in the transverse plane. IMUs and their custom software provide a valid and reliable measurement for trunk and pelvis ROM in normal individuals, and important considerations for future applications are discussed.

The biomechanical influence of transtibial Bone-Anchored limbs during walking

Individuals with unilateral transtibial amputation (TTA) using socket prostheses demonstrate asymmetric joint biomechanics during walking, which increases the risk of secondary comorbidities (e.g., low back pain (LBP), osteoarthritis (OA)). Bone-anchored limbs are an alternative to socket prostheses, yet it remains unknown how they influence multi-joint loading. Our objective was to determine the influence of bone-anchored limb use on multi-joint biomechanics during walking. Motion capture data (kinematics, ground reaction forces) were collected during overground walking from ten participants with unilateral TTA prior to (using socket prostheses) and 12-months after bone-anchored limb implantation. Within this year, each participant completed a rehabilitation protocol that guided progression of loading based on patient pain response and optimized biomechanics. Musculoskeletal models were developed at each testing timepoint (baseline or 12-months after implantation) and used to calculate joint kinematics, internal joint moments, and joint reaction forces (JRFs). Analyses were performed during three stance periods on each limb. The between-limb normalized symmetry index (NSI) was calculated for joint moments and JRF impulses. Discrete (range of motion (ROM), impulse NSI) dependent variables were compared before and after implantation using paired t-tests with Bonferroni-Holm corrections while continuous (ensemble averages of kinematics, moments, JRFs) were compared using statistical parametric mapping (p < 0.05). When using a bone-anchored limb, frontal plane pelvic (residual: pre = 9.6 ± 3.3°, post = 6.3 ± 2.5°, p = 0.004; intact: pre = 10.2 ± 3.9°, post = 7.9 ± 2.6°, p = 0.006) and lumbar (residual: pre = 15.9 ± 7.0°, post = 10.6 ± 2.5°, p = 0.024, intact: pre = 17.1 ± 7.0°, post = 11.4 ± 2.8°, p = 0.014) ROM was reduced compared to socket prosthesis use. The intact limb hip extension moment impulse increased (pre = -11.0 ± 3.6 Nm*s/kg, post = -16.5 ± 4.4 Nm*s/kg, p = 0.005) and sagittal plane hip moment impulse symmetry improved (flexion: pre = 23.1 ± 16.0 %, post = -3.9 ± 19.5 %, p = 0.004, extension: pre = 29.2 ± 20.3 %, post = 8.7 ± 22.9 %, p = 0.049). Residual limb knee extension moment impulse decreased compared to baseline (pre = 15.7 ± 10.8 Nm*s/kg, post = 7.8 ± 3.9 Nm*s/kg, p = 0.030). These results indicate that bone-anchored limb implantation alters multi-joint biomechanics, which may impact LBP or OA risk factors in the TTA population longitudinally.

The Effect of Postural Restoration Institute Training on Selected Kinematic Variables of Lower Limbs and Pelvis During Walking in Middle-Aged Men With Nonspecific Chronic Low Back Pain: A Prospective Observational Study

Background and Aims Concerning the effectiveness of training on people with chronic low back pain, the present study aimed to evaluate the effect of postural restoration institute (PRI) training on lower limb kinematics during walking in middle-aged subjects with discogenic low back pain. Methods In this prospective observational quasi-experimental study, 42 people participated in three groups: people without low back pain (healthy group, n=14) and people with low back pain in two groups (intervention group, n=14; and control group, n=14). Kinematic data were recorded by 7 Qualisys cameras with a frequency of 100 Hz in the pretest and post-test. Analysis of variance with repeated measures was used in SPSS software version 23 at a significance level 0.05. Results The results showed that people with low back pain in the intervention and control groups walk with a slower velocity, lower cadence, and shorter step length than healthy individuals for both right and left limbs. However, after the PRI training, the intervention group showed a significant increase in those three variables. Furthermore, there were significant differences between the healthy group and the two groups of intervention and control in the range of motion (ROM) for the pelvis in the sagittal and frontal planes, the right hip joint in the horizontal plane, the right ankle in the frontal plane, the left hip joint in the sagittal and horizontal planes as well as the left ankle in the sagittal plane. After applying PRI, the differences between the healthy and the intervention groups regarding the pelvis ROM on the sagittal plane, the right ankle ROM on the sagittal plane, the left hip joint ROM on the frontal plane, and the left knee ROM on the sagittal plane were minimized and became insignificant. Conclusion The present study’s findings confirmed the effectiveness of using PRI training in improving biomechanical indicators, such as the range of joint movements and increasing the velocity and step length of walking, to treat and manage the performance of people with discogenic chronic low back pain.

Gait alterations in patients with adult spinal deformity

Adult spinal deformity patients (ASD) experience altered spinal alignment affecting spatiotemporal parameters and joint kinematics. Differences in spinal deformity between patients with symptomatic idiopathic scoliosis (ID-ASD) and patients with "de novo" scoliosis (DN-ASD) may affect gait characteristics differently. This study aims to compare gait characteristics between ID-ASD, DN-ASD, and asymptomatic healthy matched controls. In this observational case-control study, ID-ASD (n=24) and DN-ASD (n=26) patients visiting the out-patient spine clinic and scheduled for long-segment spinal fusion were included. Patients were matched, based on age, gender, leg length and BMI, with asymptomatic healthy controls. Gait was measured at comfortable walking speed on an instrumented treadmill with 3D motion capture system. Trunk, pelvic and lower extremities range of motion (ROM) and spatiotemporal parameters (SPT) are presented as median (first and thirds quartile). Independent t-test or Mann-Whitney U test was used to compare ID-ASD, DN-ASD and controls. Statistical Parametric Mapping (independent t-test) was used to compare 3D joint kinematics. DN-ASD patients walk with increased anterior trunk tilt during the whole gait cycle compared with ID-ASD patients and controls. ID-ASD walk with decreased trunk lateroflexion compared with DN-ASD and controls. DN-ASD showed decreased pelvic obliquity and -rotation, increased knee flexion, and decreased ankle plantar flexion. ID-ASD and DN-ASD displayed decreased trunk, pelvic and lower extremity ROM compared with controls, but increased pelvic tilt ROM. ID-ASD patients walked with comparable SPT to controls, whereas DN-ASD patients walked significantly slower with corresponding changes in SPT and wider steps. DN-ASD patients exhibit distinct alterations in SPT and kinematic gait characteristics compared with ID-ASD and controls. These alterations seem to be predominantly influenced by sagittal spinal malalignment and kinematic findings in ASD patients should not be generalized as such, but always be interpreted with consideration for the nature of the ASD.

Pilot study of locomotor asymmetry in horses walking in circles with and without a rider

Background Horses commonly show asymmetries that manifest as left (L)-right (R) differences in vertical excursion of axial body segments. Moving on a circle confounds inherent individual asymmetries. Our goals were to evaluate individual and group asymmetry patterns and compare objective data with subjective impressions of side preference/laterality in horses walking on L and R circles. Methods Fifteen horses walked on L and R circles unridden and ridden on long and short reins. Optical motion capture (150 Hz) tracked skin-fixed markers. Variables were trunk horizontal angle; neck-to-trunk angle; vertical range of motion (ROM) for the head, withers and sacrum; ROM for pelvic roll, pitch, and yaw; mean pelvic pitch; and ROM for hip, stifle and tarsal joints. Differences between inside and outside hind steps were determined for vertical minima and maxima of the head (HMinDiff/HMaxDiff), withers (WMinDiff/WMaxDiff) and sacrum (PMinDiff/PMaxDiff). Subjective laterality was provided by owners. Data analysis used mixed models, first without and then with subjective laterality. Iterative k-means cluster analysis was used to associate biomechanical variables with subjective laterality. Results PMaxDiff, PMinDiff and WMaxDiff indicated R limb asymmetry in both directions. WMinDiff indicated L (inside) fore asymmetry for L direction but was close to zero for R direction. Hip ROM was significantly smaller for the inside limb in both directions (L inside/outside: 16.7° vs. 20.6°; R: 17.8° vs. 19.4°). Stifle ROM was significantly larger for the inside limb in both directions (L: 43.1° vs. 39.0°; R: 41.9° vs. 40.4°). Taking the general direction effect into account the R hip and L stifle had larger ROM. Adding laterality to the models (seven horses L- vs. six horses R-hollow), PMaxDiff R hind asymmetry was more obvious for L-hollow horses than for R-hollow horses. L-hollow horses had greater pelvic roll ROM moving in L vs. R direction. L-hollow horses had smaller inside and greater outside hip joint ROM in L vs. R direction. R-hollow horses had a significant difference in HMinDiff between L (0 mm) and R (−14 mm) directions, indicating less head lowering at outside forelimb midstance in R direction, and larger outside tarsal ROM in R (38.6°) vs. L (37.4°) direction (p ≤ 0.05). The variables that agreed most frequently with subjective laterality in cluster analysis were pelvic roll ROM, followed by HMinDiff and PMaxDiff. Conclusion Differences between horses walking in L and R directions were found both at group and individual levels, as well as evidence of associations with subjective laterality. Horses maintained more symmetric hip and stifle ROM and withers vertical motion when walking on the R circle. Findings suggest that left and right lateralised horses may not be perfect mirror images. Pelvic roll ROM emerged as a promising variable to determine laterality in walk as perceived by the rider, especially when considered together with other variables.

Differences in Kinematic Changes From Self-Selected to Fast Speed Gait in Asymptomatic Adults With Radiological Signs of Femoro-Acetabular Impingement.

Femoro-acetabular impingement (FAI) may present as alterations in the skeletal morphology of the hip. Repercussions of FAI can be witnessed in self-selected speed walking as well as physical exercise such as running or fast speed walking. The aim of this study was to investigate changes in kinematics at different gait speeds in subjects presenting with radiological findings invoking FAI. One hundred thirty asymptomatic adults underwent biplanar X-rays with a calculation of 3D hip parameters: acetabular anteversion, abduction and tilt, vertical center edge angle (VCE), femoral anteversion, neck-shaft angle, acetabular coverage of the femoral head, femoral head diameter and neck length. Parameters were classified according to FAI clinical thresholds. Two groups were created: Control group (63 subjects having up to one subnormal hip parameter in favour of FAI) and Radiographic FAI group (67 subjects having ≥2 subnormal hip parameters that might cause FAI). All subjects underwent 3D gait analysis at self-selected and fast speed, from which kinematic parameters were generated. Arithmetic differences between fast and self-selected speed gait were considered as gait changes. Subjects in the Radiographic FAI group had decreased acetabular tilt (24 vs. 19˚), anteversion (19 vs. 16˚), abduction (55 vs. 53˚), femoral anteversion (18 vs. 14˚) and increased VCE (29 vs. 33˚, all p<0.05), compared to controls.Changes from self-selected to fast speed showed that subjects in the Radiographic FAI group had lower range of motion (ROM) pelvic rotation (7 vs. 4˚) and ROM hip flexion/extension (10 vs. 7˚), reduced hip extension (-4 vs. -2˚) and step length (16 vs. 13 cm; all p<0.05). The Radiographic FAI group had decreased acetabular abduction, anteversion and femoral anteversion in favour of FAI. When adapting from self-selected to fast speed gait, the Radiographic FAI group seemed to limit pelvic rotation and hip flexion/extension resulting in a decrease in step length. These kinematic limitations were previously reported in subjects with symptomatic FAI. Gait analysis could be considered as a functional diagnostic tool to assess FAI along with radiological assessment.

Back motion in unridden horses in walk, trot and canter on a circle

Equine back function is of concern to riders, as well as to veterinarians and physiotherapists; these groups may benefit from knowledge about spinal motion on the circle. This descriptive and comparative study aimed to quantify equine neck, back and pelvic motion in walk, trot and canter on a 9 m circle. Sixteen healthy horses in training, of varying breed and conformation, were measured using optical motion capture (150 Hz), with optical markers on the poll, withers, T15, tubera coxae and lumbosacral joint. Cervicothoracic and thoracolumbar flexion–extension and lateral bending, and pelvic roll, pitch and yaw, were statistically evaluated using mixed models. Motion patterns showed distinct differences between gaits, but were generally similar between horses. The thoracolumbar back was bent towards the inside of the circle (stride mean 5-6º for all gaits). The cervicothoracic spine was more flexed in walk (18°), and more extended in canter (-4—-8°), compared to trot (6–7°), whereas the thoracolumbar spine was slightly less extended in canter than in walk. Thoracolumbar flexion–extension range of motion (ROM) increased from walk (4°) to canter (9°), as did pelvic pitch ROM (walk 7° and canter 15–16°), while back lateral bending ROM and pelvic yaw ROM were lowest in trot. Taken together, the study findings suggest that neck and back motion patterns on the circle reflect an interaction between the constraints of circular movement, and the mechanics and characteristics of each gait.

A new system to measure the trunk angle and pelvis angle during wheelchair propulsion.

The number of wheelchair users is increasing as the population ages. However, there is still lack of tools to objectively assess posture during wheelchair propulsion. The purpose of this study was to develop a system to measure trunk and pelvis ROM (range of motion) while driving a wheelchair and to assess the reproducibility of the measured posture changes and cyclic fluctuations during propulsion. Motion recorders were attached to the sternum and pelvis of fifteen healthy adults, and a pressure sensor was attached to the right heel. Subjects drove a standard wheelchair using their right leg and trunk and pelvis ROM was measured in two separate sessions. To detect the trend of postural changes during propulsion, a trend curve was computed from the measured ROM using a low-pass filter and then subtracted from the measured ROM waveforms. The resulting curves were normalized and averaged, and the maximum, minimum, and amplitude of the cyclic variation during propulsion were assessed for reproducibility. Intraclass correlation coefficients of the maximum, minimum, and amplitude ranged from 0.65 to 0.84. The proposed method can estimate the posture change and the periodic fluctuation during wheelchair propulsion with high reproducibility.

Adaptations in equine axial movement and muscle activity occur during induced fore- and hindlimb lameness: A kinematic and electromyographic evaluation during in-hand trot.

The inter-relationship between equine thoracolumbar motion and muscle activation during normal locomotion and lameness is poorly understood. To compare thoracolumbar and pelvic kinematics and longissimus dorsi (longissimus) activity of trotting horses between baseline and induced forelimb (iFL) and hindlimb (iHL) lameness. Controlled experimental cross-over study. Three-dimensional kinematic data from the thoracolumbar vertebrae and pelvis, and bilateral surface electromyography (sEMG) data from longissimus at T14 and L1, were collected synchronously from clinically nonlame horses (n= 8) trotting overground during a baseline evaluation, and during iFL and iHL conditions (2-3/5 AAEP), induced on separate days using a lameness model (modified horseshoe). Motion asymmetry parameters, maximal thoracolumbar flexion/extension and lateral bending angles, and pelvis range of motion (ROM) were calculated from kinematic data. Normalised average rectified value (ARV) and muscle activation onset, offset and activity duration were calculated from sEMG signals. Mixed model analysis and statistical parametric mapping compared discrete and continuous variables between conditions (α= 0.05). Asymmetry parameters reflected the degree of iFL and iHL. Maximal thoracolumbar flexion and pelvis pitch ROM increased significantly following iFL and iHL. During iHL, peak lateral bending increased towards the nonlame side (NLS) and decreased towards the lame side (LS). Longissimus ARV significantly increased bilaterally at T14 and L1 for iHL, but only at LS L1 for iFL. Longissimus activation was significantly delayed on the NLS and precipitated on the LS during iHL, but these clear phasic shifts were not observed in iFL. Findings should be confirmed in clinical cases. Distinctive, significant adaptations in thoracolumbar and pelvic motion and underlying longissimus activity occur during iFL and iHL and are detectable using combined motion capture and sEMG. For iFL, these adaptations occur primarily in a cranio-caudal direction, whereas for iHL, lateral bending and axial rotation are also involved.

Effectiveness of Mechanical Horse-Riding Simulator-Based Interventions in Patients with Cerebral Palsy-A Systematic Review and Meta-Analysis.

Mechanical horse-riding simulator (HRS) exercises are a type of therapy based on the use of robotic or mechanical devices that produces movement similar to a real horse with the aim of simulating hippotherapy. This review analyses the effectiveness of HRS therapies in patients with cerebral palsy (CP). A systematic review and a meta-analysis were carried out by searching studies in PubMed Medline, SCOPUS, Web of Science, CINAHL, PEDro and SciELO up until October 2022. We selected clinical trials that assessed the effectiveness of HRS therapy, compared to other interventions, in patients with CP. The main variables were gross motor function (its global score and dimensions, such as sitting ability), functional balance, spasticity, hip range of motion (ROM), posturographic balance and satisfaction. The risk of bias was assessed using the Cochrane Risk of Bias Tool. The pooled effect was calculated using Cohen's Standardized Mean Difference (SMD) for a 95% confidence interval (95% CI). Twelve studies were included in the systematic review, and 10 were included in the meta-analysis, providing data from 343 patients with spastic diplegic CP. Our findings revealed that HRS plus physiotherapy is more effective than physiotherapy in improving the total gross motor function (SMD 0.98; 95% CI 0.35-1.62), sitting ability of the gross motor function (SMD 0.84; 95% CI 0.32-1.36) and functional balance (SMD 0.6; 95% CI 0.1-1.08), and HRS therapy is better than sham to improve pelvic abduction ROM (SMD 0.79; 95% CI 0.21-1.37). Horse-riding simulator-based therapy is an effective therapy to improve gross motor function, functional balance and abduction pelvic ROM in children with CP, in comparison to physiotherapy or sham.

Is there a correlation between isometric muscle strength and the kinematics of the pelvis, hip and knee during functional tasks in women with patellofemoral pain?

ObjectivesTo evaluate the correlation between isometric muscle strength of the hip abductors (HABD) and lateral rotators (HLR) with the range of motion (ROM) of the pelvis/hip in the frontal/transverse planes, respectively, and between the strength of the knee extensors (KExt) with the ROM of the knee in the sagittal plane during seven tasks. DesignCross-sectional study. SettingLaboratory. ParticipantsThirty-five women with patellofemoral pain. Main outcome measuresMaximum isometric muscle strength of the HABD, HLR, and KExt was measured using a manual dynamometer, and pelvis and lower limbs kinematics were evaluated using 3D optical system during gait, ascending and descending stairs, the forward and lateral step down tests, and the propulsion and landing phases of the single leg hop test (SLHT). ResultsA weak correlation was found between KExt strength and knee ROM in the sagittal plane (p = 0.05; r = −0.33) during SLHT landing, and a moderate correlation between HABD strength and ROM of pelvic obliquity (p < 0.01; r = 0.50) during ascending stairs. ConclusionsThe lower strength of KExt has a weak correlation with higher knee flexion during the landing phase of the SLHT, and the lower strength of HABD has a moderate correlation with lower pelvis ROM in the frontal plane when ascending stairs.

Effect of Ground and Raised Poles on Kinematics of the Walk

Walking over poles is a commonly employed training and rehabilitation tool and it is crucial to understand its effect on equine locomotion, particularly joint range of motion (ROM). The study aimed to compare the effect of ground poles (GP) and raised poles (RP) on limb kinematics and poll, wither and pelvic ROM at walk. It was hypothesized that walking over poles would increase joint ROM but have no effect on poll, wither and pelvic ROM compared to no poles (NP). Forty-one horses were walked in-hand over NP, GP (10 cm) and RP (26 cm) in a crossover design. Limb kinematics were determined via two-dimensional motion capture (240 Hz). Poll, wither, tubera sacrale, and left/right tuber coxae ROM were determined by inertial motion units (100 Hz). Multivariable mixed effects linear regression analyses were carried out. Walking over poles increased limb joint ROM, through increased swing flexion, compared to NP. There was a greater effect over RP compared to GP. Significant reductions in craniocaudal ROM of the wither, tuber coxae and tuber sacrale were observed over GP and RP. Mediolateral ROM of tuber coxae and tuber sacrale increased over GP and RP and was greatest over RP. Wither ROM was increased over RP only. Set-up and height of the poles used here may not extrapolate to other scenarios. Walking over poles appears to be effective at increasing joint ROM via an increase in mid swing flexion, without vertical excursion of the trunk, compared to normal locomotion, which supports the use of poles for rehabilitation.

Lumbopelvic postural differences in adolescent idiopathic scoliosis: A pilot study

BackgroundA primary etiology of adolescent idiopathic scoliosis (AIS) is currently unknown, but poor postural control of the spinal extensor musculature has been identified as an AIS risk factor. Identifiable postural differences would aid in advancing the precise postural behaviors that should be modified during Physiotherapy Scoliosis Specific Exercise (PSSE) to help limit the progression of AIS. Research questionAre there any determinable differences in lumbopelvic posture or range of motion between subjects with AIS and controls? MethodsThis prospective cohort pilot study consisted of 53 subjects (27 AIS and 26 control) aged 11–17 years. Subjects had their lumbopelvic posture assessed and monitored using the ViMove DorsaVi sensor package. All subjects underwent a live assessment to obtain initial lumbopelvic (LP) range of motion (ROM) measurements. Subjects were then monitored while continuing with normal activities of daily living (ADLs) for 12 h. With an alpha level of 0.05, nonparametric analyses were performed for each variable via a Mann-Whitney U-test. ResultsDuring the live assessment, controls exhibited a significantly greater anterior pelvic tilt ROM in the sitting position than the AIS group (p = 0.0433). When compared to female controls, females with AIS had a sitting pelvic tilt ROM that was significantly more retroverted (p = 0.0232) and less anteverted (p = 0.0010). During ADLs, female controls exhibited a higher total number of extension events than their female with AIS (p = 0.0263). These associations did not strengthen with greater spinal deformity. SignificanceThis work demonstrates postural differences between patients with AIS and controls. Further study is necessary to determine why patients with AIS adopt these postures, and if PSSEs can be utilized to limit the progression of AIS.

1450 Relationship between Spinopelvic Parameters and Symptomatic Femoroacetabular Impingment: A Scoping Review

Abstract Aim Reports have shown that spinopelvic mobility influences the outcome following total hip arthroplasty. The aim of this scoping review was to investigate the relationship between spinopelvic parameters (SPP) and symptomatic femoroacetabluar impingement (FAI). Method A systematic computer search of EMBASE, PubMed and Cochrane for literature related to SPPs and FAI was undertaken as per PRISMA guidelines. Clinical outcome studies and prospective/retrospective studies that investigated the role of SPPs in symptomatic FAI were included. Review articles, case reports and book chapters were excluded. Information extracted pertained to symptomatic cam deformities, pelvic tilt, deviations in acetabular version, decreases in pain-free hip range of motion (ROM) on dynamic hip movements and radiological signs of FAI. Results The literature search identified 46 papers out of 1168 investigating the link between SPPs and pathological processes characteristic of FAI. Anteior pelvic tilt was associated with radiographic over-coverage parameters of FAI. Three studies associated FAI pathology with a greater pelvic incidence (PI), while four associated it with a smaller PI. In dynamic movements, decreased posterior pelvic tilt and reduced saggital pelvic ROM was found in symptomatic FAI patients during hip flexion. Conclusions Our study shows that spinopelvic parameters can influence radiological and clinical manifestations of FAI, with pelvic incidence, acetabular version and muscular imbalances being aetiologically implicated. Individual spinopelvic mobility may predispose to the development of FAI, which may be amenable to non-surgical management. If FAI pathoanatomy already exists however, sagittal pelvic parameters can influence whether FAI symptoms develop, and the extent to which they do so.

The influence of maturation and sex on pelvis and hip kinematics in youth distance runners

ObjectivesThis study aimed to investigate differences in stance phase pelvic and hip running kinematics based on maturation and sex among healthy youth distance runners. DesignCross-Sectional. Methods133 uninjured youth distance runners (M = 60, F = 73; age = 13.5 ± 2.7 years) underwent a three-dimensional running analysis on a treadmill at a self-selected speed (2.8 ± 0.6 m·s−1). Participants were stratified as pre-pubertal, mid-pubertal, or post-pubertal according to the modified Pubertal Maturational Observation Scale. Stance phase pelvis and hip range of motion (RoM) and peak joint positions were extracted. Two-way ANCOVAs (sex, maturation; covariate of running velocity) were used with Bonferroni-Holm method to control for multiple comparisons with a target alpha level of 0.05. ResultsA two-way interaction between sex and maturation was detected (p = 0.009) for frontal plane pelvic obliquity RoM. Post-hoc analysis identified a maturation main effect only among females (p˂0.008). Pelvic obliquity RoM was significantly greater among post-pubertal (p = 0.001) compared to pre-pubertal females. Significant main effects of sex (p = 0.02), and maturation (p = 0.01) were found for hip adduction RoM. Post-hoc analysis indicated a significant increase in hip adduction RoM from pre-pubertal to post-pubertal female runners (p = 0.001). A significant main effect of sex was found for peak hip adduction angle (p = 0.001) with female runners exhibiting greater maximum peak hip adduction compared to males. ConclusionsMaturation influences pelvic and hip kinematics greater in female than male runners. Sex differences became more pronounced during later stages of puberty. These differences may correspond to an increased risk for running-related injuries in female runners compared to male runners.

Impaired Lower Extremity Biomechanics, Hip External Rotation Muscle Weakness, and Proximal Femoral Morphology Predict Impaired Single-Leg Squat Performance in People With FAI Syndrome

Background: Impairments in squat depth have been reported in patients with femoroacetabular impingement syndrome (FAIS). However, little is known about single-leg squat (SLS) performance in these patients, despite this task being commonly used in the rehabilitation and training settings. Purpose/Hypothesis: The aims of this study were (1) to investigate whether patients with FAIS demonstrate differences in SLS performance compared with healthy controls and (2) to determine whether dynamic range of motion (ROM), muscle strength, hip morphologic measures, hip pain, and hip-specific function predict SLS performance in patients with FAIS. We hypothesized that patients with FAIS would demonstrate impaired SLS performance and that impaired hip biomechanics, muscle strength, and hip-specific function would predict squat performance in patients with FAIS. Study Design: Controlled laboratory study. Methods: Three-dimensional (3D) kinematic data were collected at 100 Hz using a 20-camera 3D motion capture system during 3 SLS trials in 34 patients with FAIS and 26 healthy controls. Isometric muscle strength was tested with a stationary handheld dynamometer in all participants. Squat performance was quantified by squat depth (in meters), and the biomechanical variables of dynamic ROM of the pelvis, the hip, the knee, and the ankle in all planes were calculated. In patients with FAIS, femoral and acetabular morphology were measured using radiographic alpha angles and lateral center-edge angles. Hip pain and hip-specific function were measured using the visual analog scale for pain and the Hip Outcome Score Activities of Daily Living subscale, respectively. Two-tailed independent-samples t tests were used to determine between-group differences for squat depth, dynamic ROM variables, and muscle strength. A hierarchical multiple linear regression (MLR) model was used to determine whether biomechanical variables, muscle strength, hip morphology measures, hip pain, and hip-specific function were predictors of squat depth. All statistical analyses were performed using SPSS Version 26. Results: There were no between-group differences in age (FAIS, 30.0 ± 7.0 years vs controls, 27.3 ± 7.0 years; P = .18) or body mass index (FAIS, 23.1 ± 2.8 vs controls, 22.6 ± 3.2; P = .51). Squat depth was less in patients with FAIS compared with healthy controls (FAIS, 0.24 ± 0.4 m vs controls, 0.29 ± 0.05 m; P < .001). In the sagittal plane, patients with FAIS demonstrated less dynamic ROM of the hip (FAIS, 67.8°± 12.4° vs controls, 79.2°± 12.5°; P = .001) and the knee (FAIS, 71.9°± 9.4° vs controls, 78.9°± 13.2°; P = .02) compared with controls. Patients with FAIS also demonstrated a less dynamic coronal plane pelvis ROM (FAIS, 11.3°± 5.0° vs controls, 14.4°± 6.7°; P = .044). Patients with FAIS had reduced hip muscle strength of the hip external rotator (FAIS, 1 ± 0.3 N/kg vs controls, 1.2 ± 0.3 N/kg; P = .034), hip internal rotator (FAIS, 0.8 ± 0.3 N/kg vs controls 1 ± 0.3 N/kg; P = .03), and hip flexor (FAIS, 4 ± 1.1 N/kg vs controls, 4.8 ± 1.2 N/kg; P = .013) muscle groups. The hierarchical MLR revealed that the dynamic ROM of the hip, the knee, and the pelvis, the hip external rotation muscle strength, and the femoral alpha angles were all significant predictors of squat performance, and the final MLR model explained 92.4% of the total variance in squat depth in patients with FAIS. Conclusion: Patients with FAIS demonstrate impaired SLS squat performance compared with healthy controls. This impaired squat performance is predominantly predicted by sagittal plane knee and hip biomechanics and hip external rotator strength, and less by frontal plane pelvic ROM and hip morphology in patients with FAIS. Clinical Relevance: Clinicians should focus treatment on improving dynamic ROM and hip external rotator muscle strength to improve squat performance; however, femoral morphology should also be considered in the treatment paradigm.

Are there common walking gait characteristics in patients diagnosed with late-onset Pompe disease?

Late-onset Pompe disease (LOPD) is a rare disease, defined as a progressive accumulation of lysosomal glycogen resulting in muscle weakness and respiratory problems. Anecdotally, individuals often have difficulties walking, yet, there is no three-dimensional data supporting these claims. We aimed to assess walking patterns in individuals with LOPD and compare with healthy individuals. Kinematic, kinetic and spatiotemporal data were compared during walking at a self-selected speed between individuals with LOPD (n=12) and healthy controls (n=12). Gait profile scores and movement analysis profiles were also determined to indicate gait quality. In comparison with healthy individuals, the LOPD group demonstrated greater thoracic sway (96%), hip adduction angles (56%) and pelvic range of motion (77%) and reduced hip extensor moments (36%). Greater group variance for the LOPD group were also observed. Individuals with LOPD had a slower (15%) walking speed and reduced cadence (7%). Gait profile scores were 37% greater in the LOPD group compared to the healthy group. Proximal muscular weakness associated with LOPD disease is likely to have resulted in a myopathic gait pattern, slower selected walking speeds and deviations in gait patterns. Although individuals with LOPD presented with some common characteristics, greater variability in gait patterns is likely to be a result of wide variability in phenotype spectrum observed with LOPD. This is the first study to examine walking in individuals with LOPD using instrumented gait analysis and provides an understanding of LOPD on walking function which can help orientate physiotherapy treatment for individuals with LOPD.

Effects of wearing raised-heel insoles for 60 days on physical functions: focusing on adult males in their twenties

Background and Objectives: As men frequently use raised-heel insoles (RHIs) for a cosmetic purpose rather than a functional purpose in daily life, they are exposed to the risk of musculoskeletal disorders. The objective of this study was to evaluate the effects of wearing RHIs for 60 days on overall body functions and mechanical adaption. Materials and Methods: This study measured pelvic range of motion (ROM), balance, two-point discrimination (2PD), ankle joint ROM, lower back pain (LBP), muscle tone, stiffness, and decrement in male subjects in their 20s. Subjects wore RHIs (5 cm) for 8 h per day for 8 weeks (60 days). Measurements were conducted at 0, 30, and 60 days after the experiment began. Repeated-measures one-way analysis of variance (ANOVA) was performed to examine the effects of wearing duration (0, 30, and 60 days) on variables followed by a post-hoc test (Dunnett T3) when there was a significant difference. Results: Pelvic ROM decreased (p &lt; 0.01), whereas static balance and 2PD increased (p &lt; 0.001, p &lt; 0.01, respectively) when the duration of wearing RHIs increased. The pelvic ROM on day 0 was significantly different from that on day 60 (p = 0.01). Static balance showed significant differences between day 0 and day 60 or day 30 (p = 0.000, p = 0.000, respectively). Dynamic balance, ankle joint ROM, and LBP did not differ significantly. The muscle tone of the plantar flexors (medial gastrocnemius) increased (p &lt; 0.05), whereas decrement decreased (p &lt; 0.05). Conclusions: It was found that wearing RHIs for a long time would adversely affect the human body. Wearing RHIs for a long time decreased pelvic ROM, whereas static balance and 2PD increased. It might have affected the overall body functions by increasing the muscle tone of the plantar flexors and worsening dynamic stiffness at the same time. The clinical significance lies in the fact that wearing RHIs for long durations would adversely affect the human body.

The relationships between pelvic range of motion, step width and performance during an athletic sprint start

ABSTRACT The aims of this study were (a) to describe the kinematics underlying the phenomenon of the knee of the swing leg passing medially in front of the athlete during the single push (SP) phase of the block sprint start, and (b) to determine the relationships between block phase pelvis range of motion (RoM), 1st step width and block phase performance. Three-dimensional kinematic data (250 Hz) were collected from eleven competitive sprinters (100 m PB: 11.17 ± 0.41) performing maximal effort block starts. The joint angles of the rear hip with respect to the pelvis and the pelvis segment angles with respect to the laboratory coordinate system were calculated during the block start phase to the end of the 1st stance. A combination of pelvis list and rotation (not hip adduction) was coupled with the thigh of the swing leg moving medially during the SP phase. A very high positive correlation was found between pelvic list RoM and 1st step width (r = 0.799, p = 0.003). No other significant correlations were found. Attempting to reduce pelvic RoM or changing frontal and transverse plane hip joint angles to minimise medial thigh motion is unlikely to lead to an improvement to performance.

Pelvic movements during walking throughout gestation - the relationship between morphology and kinematic parameters

BackgroundMany researchers emphasize adaptations following pregnancy. Our purpose was to get more insight into how morphology interacts with the pelvic walking pattern - the segment most prone to the adaptation following altered body demands. MethodsThirty women were enrolled. Three experimental sessions were arranged according to the same protocol in the first, second and third trimesters of pregnancy. First, the anthropometric measures were taken, then walking trials at a self-selected speed were registered. At the end of the experimental session the subjects were asked to fill out a questionnaire on pain. FindingsThe sagittal plane pelvic range of motion (RoM) significantly increased throughout pregnancy. There were significant positive correlations between pelvic anthropometric dimensions and pelvic tilt and rotation primarily in the third trimester of pregnancy. Significant positive correlations were found between pelvic RoM and thigh circumference. Indicators associated with body mass increase were positively correlated with pelvic obliquity in the second trimester and pelvic tilt and rotation in late pregnancy. It is also worth noting that the individual differences were not related to back pain and that the reported correlations were observed in some but not in all trimesters. InterpretationMorphological changes following the fetus growth induced increased pelvic tilt and rotation, however, pelvis movements were not associated with back pain. Overall, the results highlight correlations between morphology and pelvis kinematic patterns in some but not in all trimesters.